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zzyzx

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About zzyzx

  • Birthday 09/01/1971

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    paramedic, RN
  1. Well, don't leave us hanging! Getting into this late...so, assuming no equipment malfunctions, why was he cyanotic with a normal SpO2? I'm stumped.
  2. I've done a similar experiment. There are so many variables that you are never going to be sure how fast the infusion will go. But the point really is, so what? Any gravity drip infusion is not intended to be very accurate, and the point is not that you "set and forget," but that you keep checking how fast the infusion is going. Just set your stop watch, and if if seems to be going a little to fast or too slow, just adjust the rate.
  3. Great thread! I also don't have RSI. I've never used Versed for a patient with trismus, but it's been my understanding that it is supposed to be effective for that. USALSFYRE wrote: "I seriously doubt midaz will a)release the neurologically caused trismus and b)do anything but screw up your CPP if given in adequate amounts to release the trismus. In the scenario above I'd be holding a scalpel if RSI wasn't available. Pharmacologic airway control should be an all or nothing proposition. Using sedatives only increases aspiration risk and sets up the can't intubate/can't ventilate scenario. Either your good enough to use it all, or your not. Halfassery has no place in airway management." Can you elaborate on this? So, Versed will drop the brain perfusion pressure because the drug is lowering the systemic BP? In a system where you don't have RSI and can't do a surgical airway, would you not try Versed to relieve trismus? We can do nasal intubation, but I don't think it would be such an easy thing to do on bad trauma. I'd love to hear more from USALFYRE and others who have experience with this situation.
  4. But could Florence Nightingale intubate in a ditch in the middle of the night in the freezing rain like medics so often do? Specially trained nurses on ambulance sounds like a good idea. And so does greatly expanding a medic's scope after requiring them to get a lot more education. The problem is, how do we pay for all that? Healthcare just keeps getting more and more expensive, and at the same time it doesn't seem to be getting any less wasteful.
  5. Terrible news. I knew he was sick, but I didn't know he had this terrible disease. That's just not fair. I met him 5 years ago, and I was surprised how different he was in person than online. Yeah, he is really going to be missed. It's nice to see that he influenced so many people here.
  6. Sorry to hear that you are having so much trouble getting a job. It's tough nowadays. The only advice I can give you is to find out what are all the ambulance companies operating in the counties near you, and to then apply for them all. You will need to keep re-applying as well. It may help you if you hand delivered your resumes. Although it's tough getting a job, the good news is that there is a lot of turnover in EMS, especially with EMT jobs. Good luck!
  7. Why this particular diagnosis? It could have been any type of vaso-vagal syncope. Actually my first thought it was postural syncope. I don't understand why your doctor is making that particular diagnosis. Or did he just suggest it as a possible cause?
  8. "Your patient may not have read the same textbook as you." What's wrong with your patient may not be as obvious as when you practiced scenarios in class. Look out for subtle clues. Also, your patient won't always immediately present as being obviously Big Sick. Be especially cautious with patients that are "slightly off" as that may be due to hypoxia or hypotension. That said, it's hard to be perceptive when we run so many BS calls. Somewhat related...
  9. In regards to keeping the ETCO2 within a certain range when you see clincial signs of brain herniation, it's my understanding that although in healthy patients the ETCO2 will match the actual PaC02, it won't match in sick patients. Am I correct in what I'm stating here--that you can't really use the ETCO2 as a guide for ventilation? I vaguely remember that there was a thread on this back in the day when VentMedic was active on this site. Sorry for my lack of references, but it's been a long day and I'm in a lazy mood, and I'm about to pour myself a nice glass of whiskey or two.
  10. I think you should pursue your interest in EMS. L.A. County is actually not a bad place to work as a new EMT as long as you can get a job with an ambulance that responds to 911 calls. You should not expect to immediatley get a job for such a company since lots of people graduate from EMT schools and everyone wants to do the 911 stuff. So, take the class, but have something else in mind that you can do until you get hired by a company that does 911. By the way, there are no EMT ambulance jobs for fire departments in L.A. County. I worked on an ambulance in L.A. for a year a while back and I still have great memories of that job. Good luck to you! Funny, but I didn't fall into EMS like other people here are saying. I already knew I wanted to be a paramedic, and I'd taken anatomy, physiology, and a medical terminology class before even taking the EMT class. Since you are likely taking those classes as pre-req's for your radiology tech school, you will have a better understanding of the things you'll learn in the EMT class.
  11. Can anyone direct me to online articles concerning CPAP? I couldn't find anything of much substance in any of my books, and a Google search just brought up a whole bunch of stuff regarding sleep apnea. Thanks!
  12. By "medic" I mean X-treme swat/tactical/Emergency Medical Services provider.
  13. http://sports.yahoo.com/soccer/blog/dirty-tackle/post/Even-the-medics-in-Brazil-put-on-a-show?urn=sow-326382
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